The climate crisis is making health inequalities worse for ethnic minorities

Climate change is set to have a ‘disastrous’ and ‘significant’ impact on respiratory health – with marginalised and minority communities feeling the worst effects.

In a new report from the Economist Intelligence Unit (EIU), researchers found that within Europe, the climate crisis is disproportionately affecting the vulnerable, such as those with underlying health conditions and the economically disadvantaged.

It was also found that climate change can lead to the onset of respiratory conditions such as chronic obstructive pulmonary disease (COPD) and asthma in previously healthy people.

The study confirmed that climate change will cause an exacerbation of existing health inequalities – where Black, Asian and ethnic minority people are more likely to get sick due to the worsening quality of air.

Sadly, we are already seeing this happen.

Eight-year-old Ella Kissi-Debrah became the first person to have air pollution listed as a cause of death in 2019.

The little girl lived 25 metres away from the busy South Circular, one of the capital’s hotspots for high levels of air pollution. Ella died in February 2013 after experiencing three years of seizures.

During that time, local air pollution levels regularly breached EU limits.

‘If local councils are agreeing building projects knowing it is an area of high pollution, then they need to be held responsible if something bad happens,’ said Ella’s mother Rosamund Adoo-Kissi-Debrah, at the time of the coroner’s ruling.

‘At the moment they are not listening but hopefully this research will mean they take the issue more seriously.’

Black Londoners are more likely to be exposed to toxic air, with Black children 4.2% more likely to be hospitalised due to exposure to high levels of nitrogen dioxide pollution than anywhere else in the country.

Black people in the UK are more likely to live in built-up urban areas and cities, and are also less likely to be able to access green spaces, and areas with cleaner air, due to systemic barriers such as affordability and experiences of racism.

Research from the Chartered Association of Building Engineers in the UK found that in urban areas Black and minority ethnic people have access to less local green space – and the space they do have is of a poorer quality.

Elizabeth Sukkar, who led the new research at Economist Impact, says the most severe consequences of climate change on respiratory health will be seen in the decades to come.

‘Pollen seasons are becoming longer and more intense, and rising temperatures can provoke environmental events, such as heavy rainfall and floods, wildfires and heatwaves, which can all affect respiratory health,’ says Elizabeth.

‘Crucially, greenhouse gases are mixing with air pollution making respiratory health worse.’   

‘I’m deeply worried about the future’

‘Air quality is not just a problem for the developing world but right here where we live in the UK. 

I’m deeply worried about the future for my own children and especially as it is people of ethnic minority backgrounds who disproportionately face the brunt of the effects of poverty, poor housing, climate change and pandemics such as Covid. 

‘To know that my children growing up, studying and working in London, are breathing the equivalent of 160 cigarettes a year is extremely distressing. 

‘Our planet is telling us that the way we are living is destructive and that we need to change our priorities to non-harming and living in a more symbiotic way with nature to even have a chance of protecting our Earth for our children, let alone their children. 

‘We need to treat and care for our air the same way we care for ourselves.’ 

Hanuman Dass, founder of NGO Go Dharmic

Race wasn’t the only factor found to impact risk for respiratory illness caused by climate change. Elizabeth says other at-risk groups include older people, who often have underlying health problems, and children, as their lungs are still developing.

‘Populations in lower socioeconomic groups are also at a greater risk from the respiratory impacts of climate change because they are more likely to live in polluted urban areas, in poorer and overcrowded housing, and have poorer overall health,’ she adds.

‘We are learning more about the social determinants of health and how healthcare systems need to better adapt to care for the most vulnerable people. The pandemic has already revealed stark inequities in our health systems. Death rates from Covid were higher for Black and Asian ethnic groups compared to white ethnic groups, and ethnic minority populations are also more likely to report being in poorer health.’

The study revealed that extreme weather events – such as soaring temperatures, forest fires, storms and desertification (where fertile areas of land dry up) – are leading to dramatically poorer air quality.

With warmer temperatures, flowering seasons are longer, creating more pollen that is more allergenic and remains in the air for longer. Higher and fluctuating air temperatures can increase the incidence and severity of respiratory infections and can increase ozone levels.

When all these factors combine, it creates a significant increase in potential deaths. The report says that ozone-related deaths alone have already jumped 20% in a decade.

The UK already has the highest number of deaths due to respiratory disease in Europe. Of 32 European countries measured in 2017 – the year for which most recent comparative data is available – the UK came bottom of the European league.

EIU analysis suggests that those most susceptible to at risk of worsening respiratory health as a result of climate change are those with chronic respiratory diseases, people aged over 65, children whose lungs are still developing, and, interestingly, people in high-income countries.

While lower socioeconomic groups are likely to be more affected within a country, the prevalence of chronic respiratory disease is highest in high-income countries – like the UK – suggesting that poorer people in rich countries are being most affected.

This again underlines how societal inequalities will impact how climate change affects public health.

In the UK, most Black, Asian and ethnic minority people live within these lower socioeconomic groups. In fact, 44 of the most deprived local authority areas in England contain four times more Black and minority ethnic groups than other areas.

What needs to happen to protect minority groups from climate change?

The report authors have suggested a number of key recommendations in response to their findings. They say urgent action is vital.

‘Going forward, better monitoring systems will be needed to understand the impact of climate change on respiratory health within all communities,’ says Elizabeth.

‘City and public health authorities will need to increase awareness of risks with specific messaging aimed at vulnerable groups where needed. Healthcare professionals can play a crucial role in advising patients with underlying lung conditions around risks, for example, avoid going outside when poor air quality is forecast and to ensure they have more personalised care.’

Nicholas Hopkinson, from the National Heart and Lung Institute, Imperial College London, says climate change and health inequality interact in many different ways.

‘The direct effects of heating (heatwaves, climate disruption, storms, floods, fires, crop failures etc.) fall disproportionately in poor areas,’ he tells Metro.co.uk. ‘In turn, people in poorer areas have less capacity to mitigate the effects of climate change. This applies to housing, shortages and price increases of food and other goods, and the ability to move to safer areas.

‘Poorer people are more likely to be in worse health to start with, and are thus more vulnerable. Climate change will also increase the risk of lung diseases which disproportionately impact the poor.’

Nicholas says that the UK’s record on inequality is ‘troubling.’

‘The political choice to maintain and increase inequality has appalling consequences for health. In particular child poverty. Many of the determinants of health across the life-course are established in early life – lack of clean air, cold damp homes, poor nutrition, limited access to educational and cultural resources. A poor start in life with disastrous consequences.’

So, can be done to lessen these health inequalities? Nicholas thinks the key is in tackling the vast divide between rich and poor.

‘We must take the necessary redistributive steps to address child poverty and reduce social inequality more generally,’ he says. ‘We can do this through maintaining the universal credit uplift, and with wealth and property taxes.

‘We have to focus hard on preventable causes of ill health so that the ability of individuals and the health and social care system to deal with climate disruption is maximised.’

Nicholas suggests taking steps needed to deliver SmokeFree 2030, by introducing a polluter pays levy on tobacco industry profits, and raising the age of sale of cigarettes from 18 to 21. As well as action on other ‘corporate determinants of ill health’ – e.g. fast food, alcohol, and gambling.

He also says there must be more done to promote active transport such as walking and cycling, and public transport, liveable cities, and low-traffic neighbourhoods.

‘This has the triple benefit of improving individual fitness, reducing the production of pollutants so local air is cleaner and reducing CO2 emissions which drive global heating,’ he adds.

Tom Delahoyde, managing director of Chiesi Limited UK, is confident that introducing measures to tackle climate change will help to reduce health inequalities.

‘As we have seen with Covid, inequality can be exacerbated by impacts of respiratory disease,’ Tom tells Metro.co.uk.

‘The health threats resulting from climate change are not equally or evenly dispensed and ultimately put the most vulnerable groups at risk.’

He says policymakers need to prioritise respiratory health in the fight against climate change, and companies need to take meaningful, measurable and independently verified actions.

‘Protecting patient health and the environment is not a matter of compromise,’ he says. ‘Our intent to not only treat the symptoms of the crisis through our products, but also to address the root causes, by constantly improving our own environmental and social impact.’

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